This book is the culmination of several seemingly separate processes that coalesced at a critical moment. One signifcant event was my most recent research. I am an academic clinical social worker. As an academic, I teach classes and conduct practice-focused research. As a licensed clinical social worker, I practice psychotherapy. I am extremely fortunate in that I get to teach and engage in research in an area that inspires passion in me: psycho- therapy. The questions that have guided my research throughout my career have been the following. What do real-live psychotherapists actually do? How do they make clinical decisions in the moment with their clients? How do they decide from the extremely complex narratives their clients share which thread they pick up on and explore? How does therapy contribute to change in peo- ple? In the great debate over whether psychotherapy is more an art or a sci- ence, I have found myself exploring the more creative aspects of the practice.
One of my studies focused on how therapists resolve boundary dilemmas. I was surprised to fnd that most of the therapists I interviewed revealed that they used their intuition or gut feeling in making the decision. The literature on ethics certainly does not support this means of decision-making. At the risk of sounding hyperbolic, this response rocked my world.